MANTENIMIENTO DEL ORDEN PÚBLICO: teoría, práctica y educación del policiamiento de los campeonatos europeos de fútbol de 2000 y 2004

As forças policiais diferenciam-se nos métodos de intervenção que utilizam para manter a lei e a ordem em grandes eventos que põem em perigo a ordem pública, a exemplo das partidas de futebol de alto risco e de certas manifestações públicas. Tradicionalmente, a ênfase no treinamento e desempenho policiais se coloca nas táticas de controle antidistúrbios e no uso de armas não letais, incluindo desde o cassetete e os produtos químicos até os canhões de água e as balas de borracha. A maior parte dos estudos geralmente deixam de lado a perspectiva policial e ignoram o fato de que os acontecimentos da ordem pública são processos intergrupais e uma consequência de interações em desenvolvimento. Neste artigo, apresentam-se os resultados de algumas pesquisas empíricas sobre a atuação da polícia na manutenção da ordem pública, que colocam em questão as perspectivas tradicionais do comportamento das massas. PALAVRAS-CHAVE: ordem pública, policiamento de futebol jogos, táticas antimotim, a dinâmica das multidões, controle de multidões. MAINTENANCE OF PUBLIC ORDER: theory, practice and teaching of the police for the European Football Championship in 2000 and 2004 Otto M.J. Adang Police forces differ in the methods of intervention used to maintain law and order in major events that endanger public order, like high risk soccer matches and certain public demonstrations. Traditionally, the emphasis on police performance and training is put on riot control tactics and use of nonlethal weapons, from batons and chemicals to water cannons and rubber bullets. Most studies generally fail to consider the perspective of the police and ignore the fact that the events of public order are intergroup processes and a consequence of interactions in development. In this paper, we present the results of some empirical research on the role of police in maintaining public order, which put into question the traditional perspectives of behavior of the masses. KEYWORDS: public order, policing of football matches, riot control tactics, dynamics of crowds, crowd control. MAINTIEN DE ‘L’ORDRE PUBLIC: théorie, pratique et formation de la police pour le Championnat Européen de Football en 2000 et 2004 Otto M.J. Adang Les forces de police s’exercent de manière différente en fonction des méthodes d’intervention utilisées pour maintenir l’ordre et faire respecter la loi dans les grandes manifestations qui mettent en danger l’ordre public, tels les matchs de football à haut risque et certaines manifestations publiques. Traditionnellement, l’accent est mis sur la formation et les performances de la police quant aux tactiques de contrôle antiémeutes et l’utilisation d’armes non létales, y compris les bâtons et les produits chimiques, les canons à eau et les balles en caoutchouc. La plupart des études ne tient généralement pas compte du point de vue de la police et ignore le fait que les événements dus à l’action de l’ordre public sont le résultat d’un processus intergroupes et la conséquence d’interactions en développement. Dans cet article, nous présentons les résultats d’une série de recherches empiriques sur le rôle de la police pour le maintien de l’ordre public, qui remet en question l’approche traditionnelle du comportement des masses. MOTS-CLÉS: ordre public, surveillance policière des matchs de football, tactiques antiémeutes, dynamique des foules, contrôle des foules. Publicação Online do Caderno CRH: http://www.cadernocrh.ufba.br   Publicação Online do Caderno CRH no Scielo: http://www.scielo.br/ccr

Researching the use of force: The background to the international project

This article provides the background to an international project on use of force by the police that was carried out in eight countries. Force is often considered to be the defining characteristic of policing and much research has been conducted on the determinants, prevalence and control of the use of force, particularly in the United States. However, little work has looked at police officers’ own views on the use of force, in particular the way in which they justify it. Using a hypothetical encounter developed for this project, researchers in each country conducted focus groups with police officers in which they were encouraged to talk about the use of force. The results show interesting similarities and differences across countries and demonstrate the value of using this kind of research focus and methodology

Cost-effectiveness of a multicomponent primary care program targeting frail elderly people

Contains fulltext : 191679.pdf (publisher's version ) (Open Access

Effects of Dementia-Care Mapping on Residents and Staff of Care Homes:A Pragmatic Cluster-Randomised Controlled Trial

BACKGROUND: The effectiveness of dementia-care mapping (DCM) for institutionalised people with dementia has been demonstrated in an explanatory cluster-randomised controlled trial (cRCT) with two DCM researchers carrying out the DCM intervention. In order to be able to inform daily practice, we studied DCM effectiveness in a pragmatic cRCT involving a wide range of care homes with trained nursing staff carrying out the intervention. METHODS: Dementia special care units were randomly assigned to DCM or usual care. Nurses from the intervention care homes received DCM training and conducted the 4-months DCM-intervention twice during the study. The primary outcome was agitation, measured with the Cohen-Mansfield agitation inventory (CMAI). The secondary outcomes included residents’ neuropsychiatric symptoms (NPSs) and quality of life, and staff stress and job satisfaction. The nursing staff made all measurements at baseline and two follow-ups at 4-month intervals. We used linear mixed-effect models to test treatment and time effects. RESULTS: 34 units from 11 care homes, including 434 residents and 382 nursing staff members, were randomly assigned. Ten nurses from the intervention units completed the basic and advanced DCM training. Intention-to-treat analysis showed no statistically significant effect on the CMAI (mean difference between groups 2·4, 95% CI −2·7 to 7·6; p = 0·34). More NPSs were reported in the intervention group than in usual care (p = 0·02). Intervention staff reported fewer negative and more positive emotional reactions during work (p = 0·02). There were no other significant effects. CONCLUSIONS: Our pragmatic findings did not confirm the effect on the primary outcome of agitation in the explanatory study. Perhaps the variability of the extent of implementation of DCM may explain the lack of effect. TRIAL REGISTRATION: Dutch Trials Registry NTR2314

Cost-Effectiveness of Parallel Versus Sequential Testing of Genetic Aberrations for Stage IV Non-Small-Cell Lung Cancer in the Netherlands

PURPOSE: A large number of targeted treatment options for stage IV nonsquamous non–small-cell lung cancer with specific genetic aberrations in tumor DNA is available. It is therefore important to optimize diagnostic testing strategies, such that patients receive adequate personalized treatment that improves survival and quality of life. The aim of this study is to assess the efficacy (including diagnostic costs, turnaround time (TAT), unsuccessful tests, percentages of correct findings, therapeutic costs, and therapeutic effectiveness) of parallel next generation sequencing (NGS)–based versus sequential single-gene–based testing strategies routinely used in patients with metastasized non–small-cell lung cancer in the Netherlands. METHODS: A diagnostic microsimulation model was developed to simulate 100,000 patients with prevalence of genetic aberrations, extracted from real-world data from the Dutch Pathology Registry. These simulated patients were modeled to undergo different testing strategies composed of multiple tests with different test characteristics including single-gene and panel tests, test accuracy, the probability of an unsuccessful test, and TAT. Diagnostic outcomes were linked to a previously developed treatment model, to predict average long-term survival, quality-adjusted life-years (QALYs), costs, and cost-effectiveness of parallel versus sequential testing. RESULTS: NGS-based parallel testing for all actionable genetic aberrations is on average €266 cheaper than single-gene–based sequential testing, and detects additional relevant targetable genetic aberrations in 20.5% of the cases, given a TAT of maximally 2 weeks. Therapeutic costs increased by €8,358, and 0.12 QALYs were gained, leading to an incremental cost-effectiveness ratio of €69,614/QALY for parallel versus sequential testing. CONCLUSION: NGS-based parallel testing is diagnostically superior over single-gene–based sequential testing, as it is cheaper and more effective than sequential testing. Parallel testing remains cost-effective with an incremental cost-effectiveness ratio of 69,614 €/QALY upon inclusion of therapeutic costs and long-term outcomes

Effectiveness of dementia follow-up care by memory clinics or general practitioners: randomised controlled trial

Objective To examine the effectiveness of post-diagnosis dementia treatment and coordination of care by memory clinics compared with general practitioners

The most efficient and effective BRCA1/2 testing strategy in epithelial ovarian cancer:Tumor-First or Germline-First?

Objective: Genetic testing in epithelial ovarian cancer (OC) is essential to identify a hereditary cause like a germline BRCA1/2 pathogenic variant (PV). An efficient strategy for genetic testing in OC is highly desired. We evaluated costs and effects of two strategies; (i) Tumor-First strategy, using a tumor DNA test as prescreen to germline testing, and (ii) Germline-First strategy, referring all patients to the clinical geneticist for germline testing.Methods: Tumor-First and Germline-First were compared in two scenarios; using real-world uptake of testing and setting implementation to 100%. Decision analytic models were built to analyze genetic testing costs (including counseling) per OC patient and per family as well as BRCA1/2 detection probabilities. With a Markov model, the life years gained among female relatives with a germline BRCA1/2 PV was investigated.Results: Focusing on real-world uptake, with the Tumor-First strategy more OC patients and relatives with a germline BRCA1/2 PV are detected (70% versus 49%), at lower genetic testing costs (€1898 versus €2502 per patient, and €2511 versus €2930 per family). Thereby, female relatives with a germline BRCA1/2 PV can live on average 0.54 life years longer with Tumor-First compared to Germline-First. Focusing on 100% uptake, the genetic testing costs per OC patient are substantially lower in the Tumor-First strategy (€2257 versus €4986).Conclusions: The Tumor-First strategy in OC patients is more effective in identifying germline BRCA1/2 PV at lower genetic testing costs per patient and per family. Optimal implementation of Tumor-First can further improve detection of heredity in OC patients.</p

Technical-efficiency analysis of end-of-life care in long-term care facilities within Europe : a cross-sectional study of deceased residents in 6 EU countries (PACE)

Background : An ageing population in the EU leads to a higher need of long-term institutional care at the end of life. At the same time, healthcare costs rise while resources remain limited. Consequently, an urgency to extend our knowledge on factors affecting efficiency of long-term care facilities (LTCFs) arises. This study aims to investigate and explain variation in technical efficiency of end-of-life care within and between LTCFs of six EU countries: Belgium (Flanders), England, Finland, Italy, the Netherlands and Poland. In this study, technical efficiency reflects the LTCFs' ability to obtain maximal quality of life (QoL) and quality of dying (QoD) for residents from a given set of resource inputs (personnel and capacity). Methods : Cross-sectional data were collected by means of questionnaires on deceased residents identified by LTCFs over a three-month period. An output-oriented data-envelopment analysis (DEA) was performed, producing efficiency scores, incorporating personnel and capacity as input and QoL and QoD as output. Scenario analysis was conducted. Regression analysis was performed on explanatory (country, LTCF type, ownership, availability of palliative care and opioids) and case mix (disease severity) variables. Results : 133 LTCFs of only one type (onsite nurses and offsite GPs) were considered in order to reduce heterogeneity. Variation in LTCF efficiency was found across as well as within countries. This variation was not explained by country, ownership, availability of palliative care or opioids. However, in the 'hands-on care at the bedside' scenario, i.e. only taking into account nursing and care assistants as input, Poland (p = 0.00) and Finland (p = 0.04) seemed to be most efficient. Conclusions : Efficiency of LTCFs differed extensively across as well as within countries, indicating room for considerable efficiency improvement. Our findings should be interpreted cautiously, as comprehensive comparative EU-wide research is challenging as it is influenced by many factors